General Misconduct Form

DigiPen (Singapore) is committed to providing all students with a rewarding and enjoyable university experience. However, we recognize that things can sometimes go wrong. We strongly encourage students to attempt to resolve incidents directly with the staff or student(s) concerned. If the matter cannot be resolved informally, you may lodge a formal report by filling in this form. You may be contacted for further information. If you are unsure, please email studentlife.sg@digipen.edu, and the Student Life and Advising (SLA) Counselor will contact you as soon as possible.

General Misconduct Form
This form aims to gather information on events, interactions, and issues of concern related to campus safety, security, student or employee behavior, and health. After submitting this form, the SLA Counselor will contact you within one to two working days for support, guidance, and follow-up.

Full Name Full Name * First Last
First name is your given name. The last name is your family/surname.
DigiPen (Singapore) Degree Program

If you are a DigiPen (Singapore) student, please indicate your degree program.
SIT Student ID

If you are an SIT or DigiPen (Singapore) student, please provide your SIT student ID.
DigiPen Email Address

If you are a DigiPen (Singapore) student, please provide your DigiPen email.
SIT Email Address or Personal Email Address *

Please provide an alternative email address for us to contact you.
Mobile number *

Please provide your mobile number so that we can contact you for support, guidance, and follow-up.
Date of the incident Date of the incident * / DD / MM YYYY
Time of the incident Time of the incident * : HH MM
Location of the incident *
Name of the student(s) and/or staff/faculty involved in the incident *
Provide a clear and detailed account of the incident *
Supporting evidence *

Attach Files

Please attach documentary evidence including any other person who can corroborate your description of the incident or grievance.
Nature of the incident *

Nature of the incident Non-Emergency Accident Emergency (Police/Ambulance called) Safety Incident Faculty Concern Vandalism Staff Concern Maintenance IT Concern Student Conduct Emotional Concern Health Concern Others (Specify) Others (Specify)
Action Taken: *

Please indicate if you have taken steps to resolve the incident informally and the outcome of the informal resolution if attempted. Please specify the actions you have taken, where appropriate.
Expected Resolution Outcome *
Minimum of 10 characters required. Currently Entered: 0 characters.
Please specify the outcome (ie. acceptable solution) you are seeking from this formal resolution.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.